Healthcare Provider Details

I. General information

NPI: 1275891723
Provider Name (Legal Business Name): DR SHARON RAIS & DR MELINDA MANN LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 OCEAN PKWY
BROOKLYN NY
11218-5913
US

IV. Provider business mailing address

575 OCEAN PKWY
BROOKLYN NY
11218-5913
US

V. Phone/Fax

Practice location:
  • Phone: 718-437-3131
  • Fax:
Mailing address:
  • Phone: 718-437-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MELINDA SUE MANN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 718-437-3131